I must say, the debate is on! I am not an extremist, as I believe in moderation but a popular topic in the field of diabetes, especially diabetes and weight loss is, as the title depicts, should we eat high carb, low fat, or low carb, high protein, mod fat. What should we eat?
Living Low Carb, great book! The author Jonny Bowden compares all the low carb diets on the market. His writing style is witty, fun, and makes complicated biochemistry seem interesting, seriously, definitely worth a read!
The author uses an analogy to clearly display how silly the current stance is for most health care providers, dietitians and associations that place huge emphasis on how carbs are absolutely essential for a healthy diet.
I love Mr Bowden's illustration:
He talks about a time he was lecturing to a large group. He tells the group that he going to divide them in half. He explains that they are going to be stranded on a deserted island. The first half will be given only carbohydrate to survive on, and the second half will be given protein and fat but zero carbohydrate. Then, he asks the audience who will be alive in 12 months.
The answer, backed by research according to his literature review, is the group that consumed protein and fat . This claim begs the question; are we being told to consume so much bloody carbohydrate when it's not essential for our survival. So I did my own lit search, not a google search but an actual lit search.
I do believe Mr Bowden and the Low Carb crew may be onto something.
The first study article written by Dyson, P and colleagues in Diabetic Medicine took 13 Type 2 diabetics and 13 non-diabetic subjects. They were randomly placed on a low carb diet (less then 40 gms per day) or the usual diet recommended by the UK diabetes association. They were assessed monthly for three months. Guess what the results were? Those assigned to the low carb eating plan, lost more weight but had minimal changes to lipids and A1C levels. "The diet was equally effective in those with and without diabetes.
So onto the next study" Okay good info, interesting.....
Another study done by Shai, Iris R.D and colleagues in the New England Journal of Medicine compared weight loss with three mainstream diets: low-fat, restricted-calorie; Mediterranean, restricted-calorie; or low-carbohydrate, non-restricted-calorie. What did they find?
When they randomly assigned 322 moderately obese subjects to one of the three group they concluded that:
"Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions."
Clear as mud right, so what they are telling us is that a lower Carb higher healthy fat diet may be a good alternative compared to the 60-75 % high carb diets normally recommended to us battling the big D.
Okay, moving on......
The last study authored by Brinkworth and colleagues in Diabetologia randomly assigned 66 obese subjects to either a low carb (40 % carb/30% protein)or high carb(55% carb/15% protein) diet. The results were "A high-protein weight-reduction diet may in the long term have a more favourable cardiovascular risk profile than a low-protein diet with similar weight reduction in people with Type 2 diabetes."
So you can loose weight, increase the good fat HDL, with no apparent adverse effect? Sounds good!
After reading the books, doing a bit of a lit review(not an exhaustive one). I try to remain unbiased, but the evidence is mounting in favour of a reduced carbohydrate way of eating. I know that the more carb I consume, the more insulin I need, the hungrier I am, the bigger my waist gets and most importantly the sugars are way harder to control.
Are you pro carb or low carb or somewhere in between?
Dyson, P. A.; Beatty, S.; Matthews, D. R.(2007). A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects, Diabetic Medicine. 24(12):1430-1435.
Shai, Iris R.D et al.(2008). Weight Loss with a Low Carbohydrate, Mediterranean, or Low-Fat Diet,
Brinkworth, G. D. 1; Noakes, M. 1; Parker, B. 1; Foster, P. 1; Clifton, P. M. (2004).
Long-term effects o advice to consume a high-protein, low-fat diet, rather than a conventional weight-loss diet, in obese adults with Type 2 diabetes: one-year follow-up of a randomised trial, Diabetologia. 47(10):1677-1686.New England Journal of Medicine. 359(3):229-241.